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rajeevkrishnadas

Benzodiazepine

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I have seen patients being started on

Lorazepam for anxiety and Temazepam for sleep... (in the same patient)

So why not Lorazepam for anxiety and sleep???? why two benzos... (2 compounds of the same class)

Similarly, some patients are on Zopiclone and Lorazepam... again why not just give lorazepam...

What is the rationale??? Lorazepam is licensed for insomnia as well...

I think it is an example of bad science...

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I have seen patients being started on

Lorazepam for anxiety and Temazepam for sleep... (in the same patient)

So why not Lorazepam for anxiety and sleep???? why two benzos... (2 compounds of the same class)

Similarly, some patients are on Zopiclone and Lorazepam... again why not just give lorazepam...

What is the rationale??? Lorazepam is licensed for insomnia as well...

[highlight]I think it is an example of bad science..[/highlight].

I agree, the last trust I worked for made it a policy that most should be on Temazapam only as both were as addictive but no need to prescribe both, AND Temazapm was cheaper hehehe

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Has anyone used clonazepam for anxiety???? I know the BNF does not indicate...

In my last job, there seemed to be a prefrence for Clonazepam........for agitation.

I earnestly tried to stop the habit of 2 benzos at a time, and meant a resistance from the SG whohighlighted 'years of experience'.

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Clonazepam actually works very well in panic disorder... perfect medication for until the ssri kicks in...  surprisingly hardly anyone uses it here...

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What about Alprazolam? I found it effective in anxiety as well.

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The issue of benzo prescription is a tricky one I feel..on one had there is the huge dependency issue and the lack of evidence for benefits in the longer term ..on the other hand it is used by clinicians with some success esp when is made to feel anxious themselves by the patients/get stuck.

I am of the opinion that benzos should be strongly considered ( apart from short-tem use as an adjunct ) in anyone with chronic disabling anxiety with a view to having psychological treatment in the longer term during which the benzo can be gradually reduced and hopefully stopped.(wishful thinking ,may be ;))

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I am for Benzos, wonderful drug. I have used lot of clonazepam in Inpatient setting for agitation/insomnia/anxiety, works well and u have more options of dosing unlike 4mg/24 of lorazepam.

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I have seen patients being started on

Lorazepam for anxiety and Temazepam for sleep... (in the same patient)

So why not Lorazepam for anxiety and sleep???? why two benzos... (2 compounds of the same class)

Similarly, some patients are on Zopiclone and Lorazepam... again why not just give lorazepam...

What is the rationale??? Lorazepam is licensed for insomnia as well...

I think it is an example of bad science...  

Agree with u. When I was SHO, i was frequently called from the wards, to prescibe Zopiclone to patients who were on shedloads of benzos- the nurses explanation being-'he has not been prescribed anything for sleep'! :o

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I have used Clonazepam in REM sleep behaviour disorders associated with Lewy body Dementia and in distressing restless legs syndrome in elderly. Does work well. As with any other drugs one has to constantly question if a drug is still indicated instead of going with the flow. If used rationally, sensibly and for short periods benzos can be very useful.

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yup i am all for clonazepam as well.it works wonders in panic attacks, social anxiety, reduces agitaion and distress, particuarly suited in ocd kind of picture. :)

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yup i am all for clonazepam as well.it works wonders in panic attacks, social anxiety, reduces agitaion and distress, particuarly suited in ocd kind of picture. :)

i was just going to say that... its good for ruminations...

But I have hardly seen anyone use it.... and the Lorazepam 4 mg issue on BNF is a bit of a nightmare... I have used upto 12 mg without any problem (in catatonia though)...

Another thing... we use trazodone for sleep, especially in the elderly... we hardly use it in adults... olanzapine low dose 2.5 mg in depression instead of a benzo for sleep... Mirtazapine 7.5 - 15mg is good for sleep...

I cannot agree more Sands... I have been in a number of situations as yours... give him something for sleep... inspite of being on Olanzapine and Lorazepam...

THE worst scenario is when... on PRN medication, you find... Lorazepam and Temazepam... one for anxiety and other for sleep... so why not Lorazepam for both???? That is just rubbish practise...

I think an audit on prescription of 2 benzodiazepines on a medication card is due...

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olanzapine low dose 2.5 mg in depression instead of a benzo for sleep... Mirtazapine 7.5 - 15mg is good for sleep...

If these are used for 'sleep purposes' aren't we streching things a bit too far considering that antipsychotics and antidepressants are serious medications with serious short term as well as long term adverse effects

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olanzapine low dose 2.5 mg in depression instead of a benzo for sleep... Mirtazapine 7.5 - 15mg is good for sleep...

If these are used for 'sleep purposes' aren't we streching things a bit too far considering that antipsychotics and antidepressants are serious medications with serious short term as well as long term adverse effects

Oh yes... so are most medications including the Z hypnotics and benzos... that we use regularly for sedation... I think its a balance of risk vs benefit... and we are talking about very low doses actually

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